• Vafa Ghaemmaghami, Jason Sperry, Mark Gunst, Randall Friese, Adam Starr, Heidi Frankel, Larry M Gentilello, and Shahid Shafi.
• Department of Surgery, Division of Burn, Trauma and Critical Care, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Mail Stop 9158, Dallas, TX 75390-9158, USA.
• Am. J. Surg. 2007 Dec 1;194(6):720-3; discussion 723.

BackgroundWe hypothesized that early use of external mechanical compression (EMC) reduces hemorrhage and mortality associated with pelvic fractures.MethodsPatients with pelvic fractures and one of the following risk factors for hemorrhage were studied retrospectively: (1) unstable fracture pattern, or (2) any fracture in patients older than 55 years of age, or (3) fracture with systemic hypotension. Starting in November of 2003, EMC was performed using circumferential pelvic binders on patient arrival and continued for 24 to 72 hours. Patients who underwent EMC (n = 118) were compared with historical controls in the preceding year (n = 119).ResultsPatients in the EMC and control groups had similar fracture patterns, age, and injury severity. EMC had no effect on mortality (23% vs 23%, P = .92), need for pelvic angioembolization (11% vs 15%, P = .35), or 24-hour transfusions (5.2 +/- 10 vs 4.6 +/- 9 U, P = .64).ConclusionsEarly EMC with pelvic binders does not reduce hemorrhage or mortality associated with pelvic fractures.

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